Calculus, or tartar as it is sometimes called, is the solid, hard mass of calcified material deposited on and adhering to the surfaces of the teeth. Calculus is composed of inorganic salts which make the calculus hard and resistant. Calculus is largely calcium phosphates, mainly hydroxyapatite with varying, but small, amounts of other inorganic salts.
Although not entirely understood, the general concept is that deposits, mostly plaque, which is a sticky film of oral bacteria and their products, become calcified with the ultimate formation on the teeth of a hard mineral consisting of calcium hydroxyapatite.
As the mature calculus develops, it becomes visibly white or yellowish in color unless stained or discolored by some extraneous agent. In addition to being unsightly and undesirable from an aesthetic standpoint, the mature calculus deposits can be constant sources of irritation of the gingiva.
Methods for chemically reducing or preventing calculus formation have been directed at affecting the process at any of several stages in its development. One approach is to develop agents which inhibit the formation of the crystalline calcium phosphate or hydroxyapatite.
A wide variety of chemical and biological agents have been suggested to retard calculus formation or to remove calculus after it is formed. The chemical approach to calculus inhibition generally involves crystal growth inhibition which prevents the calculus from forming. Mechanical removal of calculus by the dentist is necessary and is a routine dental office procedure.
The most widely used tartar control agents in dentifrices are the pyrophosphate salts. A disadvantage of pyrophosphate salts is that they cause irritation in some users and in others they cause sensitivity to the teeth.
Prevention of plaque and gingivitis can be very important to the health of individuals. Loss of teeth and other ill effects can result from poor oral health.
Gingivitis is an inflammation or soreness of the exposed gums and gingiva and is usually caused by bacteria in plaque. In mild cases the only symptom is a slight reddening of the gum tissues at the tip of the gingiva. In more severe cases the reddening spreads and the gums become swollen. Sometimes the gums bleed on brushing or when probed by a dentist. In very severe cases spontaneous bleeding of the gums occurs.
Gingivitis can often be inhibited by regular, twice daily brushing with a regular toothpaste and by the use of floss to remove plaque from between teeth. Sometimes, however, over-the-counter chemotherapeutic agents such as anti-bacterial mouthwashes or toothpastes containing anti-bacterial agents are useful in preventing gingivitis in more susceptible individuals.
Many kinds of anti-bacterial agents, when incorporated into mouthwashes or dentifrices, have been found to be at least somewhat effective in preventing gingivitis. A mouthwash containing the essential oils thymol, eucalyptus, and menthol in an alcohol/water base is currently marketed and has been shown in several clinical studies to provide a significant benefit. This product, however, has an unpleasant taste which deters use. Toothpastes containing triclosan have also been shown to be effective and are available in Europe. Cationic anti-microbial surfactants have also been suggested as anti-plaque/anti-gingivitis agents.
Enhancement of the activity of triclosan and cationic anti-microbials by zinc salts has also been reported; however, due to the unpleasant lingering taste of zinc salts, only minor levels of zinc salts have been used. Since one would expect any microbial effect of zinc salts to be due to the release of zinc ions, one would not expect insoluble zinc compounds to be effective anti-bacterials.
Gingivitis is a significant disease because it is believed that in some cases it can lead to or be a precursor to more serious gum diseases known as periodontitis.
Periodontitis is a disease which occurs below the gum line. Anaerobic bacteria collect in pockets formed between the teeth and gums, and the gums recede from teeth when serious inflammation of the gums is present, loss of alveolar bone often occurs and the patient is often at risk of loosing teeth. Periodontitis cannot generally be treated by superficial use of chemotherapeutic agents. The intervention of a dentist is required and surgery is often necessary.
Zinc oxide is used in a number of human health products. In the dental application area, it is used in dental fillings, dental cements, and dental impression materials, and it is suggested for use in a calcium hydroxide-based paste to establish an alkaline barrier inhibiting bacterial attack without gingival and periodontal irritation (see U.S. Pat. No. 4,375,968 issued Mar. 8, 1983 to M.J. Manhart). The strong alkaline properties of the calcium hydroxide are controlled by using a two part paste and mixing before use. The zinc oxide is added as a filler to the calcium hydroxide-containing first part and it acts as a moderator to slow the setting time of the final paste to about four minutes.
There is still a need for improved dentifrices which help prevent gingivitis and tartar and plaque buildup.